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Hello. This is Ariana Portallatin with the Becker's

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Dental and Dia Sobebee podcast. I'm thrilled to

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be joined today by doctor Krista Kappas, a

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private practice dentist in California.

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Doctor Kappas, thank you so much for being

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here today. It's great to meet with you.

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Thanks for having me. Yes. Definitely.

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To start us off for our listeners, can

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you introduce yourself and tell us a little

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bit about your background?

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Yeah. I

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well, you've got my name now. Yes.

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I went to University of Michigan for dental

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school

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and practice at a community clinic. And then

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I actually worked for a DSO for about

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five years

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after that, which was great experience.

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And my husband and I decided

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of sick of the Michigan winters and moved

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out to Northern California and purchased our own

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practice. We've been here for five years in,

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wine country, which has been lovely. But definitely

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a change up from the DSL life to

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owning a private practice.

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Yeah. Yeah. Definitely.

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For our first question here, what are some

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of the biggest issues that you're following in

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the dental industry right now?

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I mean, I think

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it it goes without saying on, you know,

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a lot of the Becker's titles and just

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dentistry in general. We're having a huge issue

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with staffing shortages.

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I mean, I know we're

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right now, we,

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participate with Delta Dental, and we're one of

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the few offices in our area, so we're

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slammed. But,

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getting good hygienists has been

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certainly an an issue for us.

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Yeah. Yeah. Definitely. How was your experience with

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staffing shortages when you were working at the

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DSO in Michigan versus in private practice now

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in California?

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It was different, but I think

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2020 certainly seemed to change everything. So we,

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we ended up moving here in 2020, and

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I think that was kind of the big

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shift to a lot of things that

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it really

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you know, hiring a hygienist

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back in Michigan at that time, you'd put

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out an ad, you'd get five to six

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applicants.

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Several of them would be great. You'd have

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a hard time kinda deciding who it was

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gonna be. Now it's

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I I think we had an ad out

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for,

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you know, a month and a half. And

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with our delta fees, I mean, we're basically

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paying everybody to get cleanings

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at this point with what we're paying our

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hygienists. And it's you know, we're getting people

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fresh out of school asking $75

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an hour. And Oh, okay. We're fortunate we

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did find some really good hygienists. We burned

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a good

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reputation name in our,

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area, so we've been able to find and

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recruit some other,

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experienced hygienists, but it's definitely not been easy

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to find.

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Yeah. I know. And this is something that

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I've spoken with a lot of practice owners

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about too, just the cost of hiring a

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hygienist

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with the salaries,

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that they're asking for.

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How have you seen those increase since 2020?

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So I think when we purchased our office,

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the average

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hourly pay for a hygienist was 55 an

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hour. Now we're we're at about 80 probably

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on average. And then, with that, we do

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a bonus system too. So it ends up

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being, you know, 5 to $600 a month

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extra bonus on top of that, and our

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delta fees were

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literally for a cleaning getting reimbursed less than

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that, but it's just kind of, you know,

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that it's it's however you wanna play the

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game. You know, we're we're swamped. We're busy.

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We've we're

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got bodies coming and going. So I I

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think we'd rather practice that way, but it's

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definitely

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you know, it's a challenge.

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Yeah. Is that bonus, is that something

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that you found to be helpful for recruiting

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staff?

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Definitely. And I think it's been really good

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just, for morale booster too. Basically, what we

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do is anything.

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We do a percentage of treatment,

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planned and accepted, and then also, they have

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a daily goal. Anything to get over that

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goal, they get a percentage of that as

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well.

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Nice. Okay.

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Next question here. What are you most excited

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about when it comes to dentistry right now,

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and is there anything that makes you nervous

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about the industry?

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Yeah.

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Excited. There's so much cool technology that's coming

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out right now. I mean, right now, we

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have,

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we've we're a big CEREC office. We love

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our CEREC site. I think that makes

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participating with insurance doable.

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We've been working with Pearl

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AI, which has been huge for, patient education.

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You pull up their x rays. They've got

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everything highlighted and what potentially could need,

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billings done, scaling group planning, things like that.

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It's just really great for patient education, and

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it's great too. There's sometimes that you might

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miss something. So it's it's helpful, for our

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hygienist to have that pulled up. They've already

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had a chance to kinda go through things

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with the patients before we step in the

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room, so we just have to confirm with

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them.

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I think AI is just gonna keep getting

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better and better. I think scheduling is gonna

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get better. You look at where we've come

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with chat GPT and things like that over

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the years. I think we'll probably get some

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more automated online scheduling that just works more

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efficiently and with I mean, I'm a millennial.

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I think,

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the up and coming

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generations, nobody wants to call. Nobody wants to

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talk to somebody. It's just you wanna go

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on your phone, and you wanna get whatever

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you need scheduled. You wanna pay your bill

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online, and you wanna just get that done

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at that moment. If it's 11PM at night,

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you wanna just get that scheduled. So I

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think that's all

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really

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coming and developing.

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I think three d printing is also I

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mean, we have CEREC. It's great, but it's

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not for everybody.

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We have a Sprint Ray that cost, you

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know, the setup for a sprint ray is

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about, I mean, maybe a tenth of it.

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So I think as that becomes more readily

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available,

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I mean, three d printing a crown versus

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milling a crown, you don't have any over

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mill, under mill prepping's a lot easier. So

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I think that's gonna keep getting better and

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better as materials change too.

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Great. Was there anything that makes you nervous

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about the industry too? There's a lot of

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things that make me nervous. Yeah. Oh, you

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know, it's interesting. I had a patient the

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other day,

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who was in he had a crown done

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in 02/2001. You know, he had his World

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War two hat on and everything, and he's

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been joking with me about, oh, well, I

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bet this crown cost 10 times as much

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as my crown got done in 02/2001. Like,

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well, let's let's check because you've been coming

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to this practice for that long. Let me

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pull that up. You know what?

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Ironically, you're paying $20 less than you paid

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in 02/2001. How's that for inflation for you?

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But it's just it paints such an interesting

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picture of where the dental field is going.

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I mean, our every cost has gone up

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astronomically for us, staffing costs.

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I mean, all of our,

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dental supply costs,

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your rent,

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your everything has gone up, but,

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I I do think there needs to be

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a massive change in insurance for for us

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to be able to provide high quality dental.

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I mean, you look at

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we do still participate with Delta Dental, which

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is a nonprofit

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business.

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But you look at them, they had a

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9,900,000,000.0,

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Delta Dental of California, $9,900,000,000

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revenue

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last year.

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And,

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you know, they've got their costs, obviously, in

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providing the dental care and things like that,

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but it's just kind of interesting to look

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at in any other field

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how much prices have gone up, and ours

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have really stayed stagnant or even gone down

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over the last couple of years. So I

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think that's certainly scary. You know, how are

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you gonna continue to be able to pay

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and maintain staffing if you're

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not getting reimbursed, which you need to get

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reimbursed to make that. So that that's certainly

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scary. And like we talked about staffing costs

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in general, I think, is gonna be a

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little bit of a challenge. Keeping people around,

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you look at I I think that's been

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the talk amongst dentists for the last several

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years, and you read an article. I I

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think I pulled one article up recently that

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was, dental hygiene

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magazine, and their

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solution to it was, well, you know, dental

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hygienists don't wanna stay around. They They don't

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wanna work right now. It's negative workplace culture.

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There's insufficient pay. They're feeling overworked. I think

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there's only so much you can do with

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that. You know, we're already paying our hygienist

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to be there. We're we're bonusing them. We're

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giving them an hour for every procedure. So

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there's only so much that you can really

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do

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before that's, you know, not really the issue.

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Yeah. Yeah. Definitely. What changes could be made

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to sort of help the the staffing

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challenges right now?

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I just think there needs to be a

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lot of reform in general. So I think

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looking at insurance,

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it's

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basically

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been you know, I think I was looking

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back at this, you know, in the early

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you know, like, in the sixties. Insurance was

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truly just you'd go to the dentist, they

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would reimburse.

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And it's just shifted and shifted and shifted

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to where now it's you know, I remember

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having to send

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preliminary X rays, post op X rays. We're

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getting everything

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pre authorized before we do treatment.

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We have a whole separate department just for

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dealing with insurance. We have different companies that

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we work with for insurance, and it's just

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gotten so complicated.

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Insurance maximums haven't changed. So I I definitely

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think there needs to be some sort of

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insurance reform where or we look at what

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the profitability they're actually making. I mean, of

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that 9,900,000,000.0

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in revenue from Delta,

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they did donate a $100,000,000.

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You know, I don't know what their exact

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profitability is. The CEO made over $30,000,000

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last year, which it's a huge company. I

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mean, a $9,900,000,000

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company should be compensated fairly, but I think

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there's we need to take a closer look

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at that.

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And maybe there's I don't know what the

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changes are gonna be, but it's it's not

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going in the right direction for dentists to

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be able to function. I think staffing wise,

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you look

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at dental hygiene education.

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There really hasn't been an increase in dental

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hygiene programs over the last twenty years.

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I think it's it's interesting in the state

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of California. You can have a expanded functions

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dental assistant

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who can place fillings. They can use high

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speed handpieces. They can use low speed handpieces.

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They can put fillings in, but they can't

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scale teeth. They can use an ultrasonic cleaner

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if they're removing,

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ortho cement, but they can't scale teeth. So

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I do think

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maybe some sort of a shift.

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You know, hygienists were there to originally help

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release the the burden on,

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dentists, but, you know, maybe there's a change

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of we've got an expanded functions assistant who

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can do simple cleanings, maybe not scaling root

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planing, things like that, kit prophines, cleanings, things

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like that. But I do think we need

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to have just generally

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dental education reform, insurance reform.

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And with that, I mean, I look at

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dental education. You know, you're graduating from school

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with $600,000

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in debt.

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Who's gonna be able to go into the

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workforce the way that it's going and make

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a $100,000

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a year and make that make sense?

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Yeah. Yeah. Definitely. A lot of interesting points

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that that you've made there.

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Our last question here, what will the most

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effective health care's leader health care leaders need

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to be successful in the next two to

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three years?

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I I think we just need to roll

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with the changes because I think a lot

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has changed. I mean, everything that I've talked

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about today, we're

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we're getting some really cool products with AI

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that will make us more efficient, make it

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things more cost effective. And I think just

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being willing to adapt and get educated to

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use these things and be willing to change

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is gonna be really crucial to being successful

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in the future.

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Okay.

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Well, that is all I have for you

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today, doctor Kappas. Thank you so much for

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joining us. Been a pleasure speaking with you

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and, looking forward to connecting with you again

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in the future. Thank you so much. Thank

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you.